BISAP Score for Pancreatitis Mortality
Bedside Index for Severity in Acute Pancreatitis (BISAP). Simple 5-point score calculated within 24h of admission to predict in-hospital mortality.
Score interpretation
BISAP 0–1: Low risk of in-hospital mortality (<1%).
→ Ward-level care. IV fluids (Ringer's lactate preferred, 250–500 mL/h). Analgesia. Nil by mouth initially. Reintroduce oral intake when pain resolves and tolerating.
BISAP 2: Moderate risk, ~2% mortality.
→ Close monitoring. Consider HDU. CT abdomen if not improving at 48–72h or clinical deterioration. GI team review.
BISAP 3: High risk, ~8% mortality.
→ HDU admission. Aggressive fluid resuscitation. CT pancreatic protocol. GI/HPB surgery consult. Monitoring for organ failure.
BISAP 4–5: Very high risk, mortality 15–22%.
→ ICU admission. ERCP if cholangitis/obstruction. Early enteral nutrition via NG/NJ. Antibiotics only if infected necrosis confirmed. HPB surgery referral for necrosectomy consideration.
Interpretation bands for the BISAP. Apply clinical judgement and local guidance.
References
- Wu BU, et al. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57(12):1698–1703.
Related
Curated clinical cross-links plus same-class fallbacks.
- Dobutamine (Acute HF / Stress Echo) · Inotrope / Acute Heart Failure
- Milrinone · Inodilator / Acute Heart Failure
- Mannitol (Osmotic Diuretic — Renal/Neurological) · Acute Oliguric Renal Failure / Raised ICP
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Vericiguat · Heart Failure
- Ferric Carboxymaltose · Heart Failure
- Upper GI Bleeding · BSG Guidelines 2019; NICE NG141
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
- Acute Pancreatitis · NICE; IAP/APA; ACPGBI — CG104
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.